Inspection on 28/07/09 for Mill House

This is the latest available inspection report for this service, carried out on 28th July 2009.

CQC found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Mill House 07/06/06

Mill House 08/11/05

Mill House 25/05/05

Mill House 04/10/04

Mill House 06/05/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Mill House 15 Mill Road Gt. Ryburgh Fakenham Norfolk NR21 0ED     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Debra Allen     Date: 2 8 0 7 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 29 Information about the care home Name of care home: Address: Mill House 15 Mill Road Gt. Ryburgh Fakenham Norfolk NR21 0ED 01328829323 01328829554 info@prime-life.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Prime Life Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 44 Number of places (if applicable): Under 65 Over 65 44 44 dementia old age, not falling within any other category Additional conditions: 0 0 No Service Users who need to use a wheelchair are to be accommodated in rooms 22, 23, 24 and 25. Date of last inspection Brief description of the care home Mill House accommodates 44 service users in a large extended country house. The main house is on two floors, with a single storey extension. Nine terraced bungalows also provide semi independent accommodation comprising, bedroom, sitting room and kitchen and a bathroom. The Home provides personal care to older people who are mentally frail except for those service users admitted to the bungalows. The current manager was recruited in April 2005. The Home is situated in a rural position at the end of a country lane in the village of Gt Ryburgh and overlooking the river. Most of the rooms are single and several have lovely views. The Home has a large garden and Care Homes for Older People Page 4 of 29 Brief description of the care home patio and there is a bus service to Fakenham from the village. The fees vary according to individual care and support requirements and the room/location selected. Care Homes for Older People Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: Care Services are judged against outcome groups, which assess how well a provider delivers outcomes for people using the service. The key inspection of this service has been carried out, by using information from previous inspections, information from the providers, the residents and their relatives, as well as others who work in or visit the home. This has included a recent unannounced visit to the home. This report gives a brief overview of the service and the current judgements for each outcome group. The fieldwork of this inspection was carried out over a period of eight hours and included a tour of the premises, inspection of staff and residents records and the homes records relating to health and safety. Discussions also took place with the manager, two staff members and two relatives. Care Homes for Older People Page 6 of 29 Ten questionnaires were completed or returned to the Commission by residents or their relatives/power of attorney prior to the inspection, which contained mostly very positive comments and responses. Some of the additional comments included: ...as a family we are very pleased with the support and care received at Mill House... ...The staff are always kind and patient... ...all the family have visited Mill House and the staff are always welcoming, warm and cheerful... ...[name]s room is always tidy and the bed made... ...name has told us on many occasions how much they enjoy the food... ...I am well looked after and quite happy here... ...the staff at Mill House are always very nice when I visit. They take care as best of all situations. I can never find any faults, the service is very good... ...overall the staff do their best but they are compelled to complete paperwork to the detriment of interaction with residents - not their fault... A fully completed Annual Quality Assurance Assessment (AQAA) was also submitted to the Commission prior to this inspection. One recommendation has been made as a result of this inspection. What the care home does well: Care plans are very individual, person centred and contain good evidence that comprehensive pre-admission assessments are carried out for each person before they move in to Mill House. Excellent examples of person centred care planning and individuality are recorded in the care plans. Daily notes are written respectfully, appear to be factual and relevant and included good explanations of any situations or issues that may have arisen and any remedial action taken. Excellent records have been maintained in respect of weights, nutritional screening, falls and pressure sores, with clear audit trails and risk assessments in respect of any action required or taken. All information is reviewed/evaluated on a regular basis, regardless of peoples individual ability/disability. Illness, dying and death is treated with the utmost respect by all staff and individual records in the care plans confirm peoples wishes in respect of their funeral and their cultural/religious beliefs. Residents have the opportunity to take part in a number of activities, hobbies and pastimes and are supported to maintain contact with family, and friends, according to their wishes. Very close attention is paid to people being accommodated in respect of their food likes and dislikes and individual dietary requirements are catered for. Of the ten surveys returned, five stated that they always like the meals and five stated usually. One additional comment stated: [name] has told us on many occasions how much they enjoy the food. Residents, their families and friends know their complaints will be listened to, taken seriously and acted upon and robust procedures are in place that help protect residents from abuse. Concerns and/or complaints are embraced by the manager as a means for potential future improvements and all concerns/complaints are acknowledged and addressed appropriately, in line with Mill Houses complaints procedure. The home continues to provide a clean, safe and well maintained environment for residents, with further and ongoing improvements having been made to some of the tired areas. Mill House has robust recruitment policies and practices, the staff have a good mix of skills, they are trained and competent and receive regular support and supervision. Overall, Mill House is a home, which is run in the best interests of the residents by a competent manager. Care Homes for Older People Page 8 of 29 Residents are safeguarded and the health and welfare of residents and staff are promoted and protected by the homes policies and procedures. What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 29 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents have their needs assessed prior to admission and the information is used as part of the care planning process, which helps to ensure peoples needs are met. Evidence: Three peoples care plans were looked at in detail during this inspection and each was found to be very individual, person centred and contained good evidence that comprehensive pre-admission assessments had been carried out for each person before they moved in to Mill House. Some of the areas covered as part of the pre-admission assessment included medical history, medication, physical support needs, emotional support needs, personal history/profile, hobbies, food and general likes/dislikes and daily living requirements. This information was seen to have been gathered from a number of sources such as Care Homes for Older People Page 11 of 29 Evidence: the resident, their relatives, GP, social worker and hospital staff. The care plan for a person who had recently moved into the home also contained clear evidence that they and their family had been to Mill House to look around and a full information pack was provided, which included a Statement of Purpose and Service Users Guide. Meanwhile, ten service user surveys were returned, which had been completed either by the person themselves or by a family member or Power of Attorney and some of the additional comments included: ...I was visited in hospital by the manager before moving in and had a one month trial period to see if it was suitable... ...we all made a visit beforehand. All the family have visited Mill House and the staff are always welcoming, warm and cheerful... ...the home was visited by our family, when information about the home was given. The information was given on the basis of a respite care stay, rather than a longer stay... All ten surveys were marked Yes to the question: Did you receive enough information about this home before you moved in so you could decide if it was the right place for you? Eight surveys were marked Yes to confirm a contract had been received, one survey left this section blank and another marked No stating that their relative had only just moved in. Care Homes for Older People Page 12 of 29 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person at Mill House has a detailed care plan which describes their health, personal and social care needs. Residents also have access to healthcare professionals and they are protected by the homes medication policies and procedures. All of these factors help ensure that residents health care needs are fully met. Evidence: Three care plans were looked at in-depth, and various information in respect of other people was accessed randomly, during this inspection and improvements were noted to have continued significantly since the last inspection. The main sections within the care plans were as follows: 1) Pre-assessment Details 2) Other Health Agencies Assessment Details Care Homes for Older People Page 13 of 29 Evidence: 3) Care Plan Audit, Life Profile, Hospital Admission Forms 4) Care Plans and Evaluations 5) Health Support Services and MUST (Malnutrition Universal Screening Tool) Evaluations 6) Risk Assessments and Evaluations 7) Family Interviews, Death Details and Property Lists 8) Old Personal Hygiene Charts and Daily Reports Each of the above sections was found to contain very detailed information and, additionally, contained a sub-section that clearly explained how to support each person, with dignity and respect, to maintain their independence and do as much for themselves as possible. Some of the information recorded and integrated into the care plan from the preadmission assessments included: * Diagnosis/Medical History * Mobility * Communication * Toileting * Eating and Drinking * Cleansing and Dressing * Night Care * Behaviour, Moods and Agitations * Social Activities, Interests, Hobbies, Likes and Dislikes * Finances Care Homes for Older People Page 14 of 29 Evidence: * Additional Information * Risks Identified Some excellent examples of person centred care planning and individuality were seen to be recorded in the care plans, such as: [name] prefers to be called [....] and attends to all their own personal care with no problem. Staff are to visit each morning between * and * to check if [name] is ok. [name] has their own linen and staff are to change towels and bedding on [*]day each week. [name] sleeps well, chooses when to sleep and does not want to be disturbed at night by staff. Therefore, at [name] and familys request, night staff are to peep through the bedroom window to check that they are on the bed. Another example was seen as: [name] requires one member of staff to assist with cleansing and dressing. Two staff are required for transferring to a wheelchair, using the hoist, stand-aid or glide-sheet. [name] often has broken sleep and is prone to wandering during the night. [name] needs assistance to be engaged in daily living activities to stimulate their memory [name] has been a very active person. It was also noted that residents or their representatives had signed a statement to confirm that they had participated in their care plan and agreed with the contents and to having their photograph taken for their care plan and medication records. Daily notes were seen to have been respectfully written and appeared to be factual and relevant and included good explanations of any situations or issues that may have arisen and any remedial action taken. The care records also contained information, which confirmed that residents receive care as required from external healthcare professionals such as GP, district nurse, speech therapist, physiotherapist, dieticians, falls team, occupational therapist and psychologist. Excellent records were seen to have been maintained in respect of weights, nutritional screening, falls and pressure sores, with clear audit trails and risk assessments in respect of any action required or taken. All of the information seen was also noted to have been reviewed/evaluated on a regular basis regardless of peoples individual ability/disability. Care Homes for Older People Page 15 of 29 Evidence: People are supported, where possible, to look after and administer their own medication and risk assessments are completed accordingly but for most people, medication is stored in one of two lockable trolleys and administered by appropriately trained staff. The medication records looked at during the inspection showed everything to be in order, with no errors or omissions noted. Illness, dying and death was noted and observed to be treated with the utmost respect by all staff and weighty evidence was available to confirm this, such as numerous thank you cards and compliments from family and friends, most of which stated how well the whole family, as well as their friend/relative, had been supported through a time of illness and/or death. Individual records were also seen in the care plans, which confirmed peoples wishes in respect of their funeral and their cultural/religious beliefs. Some of the comments noted (which have also been repeated in the complaints section) included: ...thank you for [name]s care and best wishes... ...always a very peaceful atmosphere... ...[name] was very well looked after and was very happy. The staff were exceptionally kind at the end of life and were also very kind and caring to me. I very much appreciated the fact that two staff came to the funeral... ...nothing but praise for [name]s care, our family was very well looked after as well as [name]... ...excellent care and a very caring home. [name] was here for two years and I have nothing but praise for the staff and management... Care Homes for Older People Page 16 of 29 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents have the opportunity to take part in a number of activities, hobbies and pastimes and are supported to maintain contact with family, and friends, according to their wishes. Evidence: Information contained within the AQAA and discussions held with the manager and staff members confirmed that Mill House provides a varied & flexible programme of activity and stimulation, comprising in-house opportunities as well as use of local amenities. Individual care plans also contained good quality and detailed information in respect of peoples personal hobbies, likes and dislikes and it was noted that the manager and staff try as much as possible to support people to continue with their enjoyed pastimes. Some of the recent in-house activities noted from the records included Holy Communion, sing-alongs, indoor games, reminiscence - photos/smelling/touches, dancing, manicure and foot spa, watching a film, songs of praise, bingo, cards, Care Homes for Older People Page 17 of 29 Evidence: exercises to music, entertainment by the piano lady, looking at old photos, art and crafts. Evidence of other social activities included a trip to Sheringham, Strawberry Fayre, picnic in Sandringham Grounds, Sandringham Tractor Tour, Fakenham Garden Centre, feeding the ducks, Cheltenham Festival, Heacham Lavender Gardens, University Boat Race, pubs/tea rooms and various other trips out. Maintaining contact with family and friends was also observed to be very highly valued by the staff and manager of Mill House and numerous photographs showed residents, staff, visitors, family and friends taking part in open days, fetes and fundraising events at Mill House. A memorable dates calendar was also seen to be available, which contained information, prompts and reminders for specific dates in each month - for example, July 2009 - Henley Royal Regatta, American Independence Day and the anniversary of the first man on the moon. It was confirmed by observations and discussions with the manager, staff and two relatives that visitors are welcome at the home at any time and residents can receive visitors in private if they so choose. It was also confirmed by discussions, observations, records seen and information in the AQAA that the staff at Mill House offer varied, wholesome and nutritious meals to residents and assist people to choose their meals on a daily basis. A good selection of finger food continues to be available to residents at all times, which are stored in clear fronted fridges in both of the dining rooms of Mill House and Mallard. Following a recommendation made at the last inspection, it was confirmed that staff have resumed eating their meals with residents, which appears to be enjoyable and beneficial for all concerned. It was also acknowledged that very close attention is paid to people being accommodated in respect of their likes and dislikes and one person was seen to have written in the comments book personally complimenting the cook on the quality of food and the way their particular dietary requirements had been catered for. Of the ten surveys returned, five stated that they always like the meals and five stated usually. One additional comment stated: [name] has told us on many occasions how Care Homes for Older People Page 18 of 29 Evidence: much they enjoy the food. Care Homes for Older People Page 19 of 29 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents, their families and friends know their complaints will be listened to, taken seriously and acted upon. Robust procedures are in place that help protect residents from abuse. Evidence: From information received by the Commission, records seen, observations and discussions, it was evident that the manager and staff at Mill House have consistently strived to improve the service provided and have maintained the improvements acknowledged at the previous inspection. Additionally, any concerns and/or complaints have been embraced by the manager as a means for potential future improvements and all concerns/complaints were seen to have been acknowledged and addressed appropriately, in line with Mill Houses complaints procedure. It was noted that external professionals have also been invited and included in dealing with concerns, complaints or issues raised (where necessary and appropriate) and all records were seen to be clearly maintained and provided a clear audit trail of each situation. It was also noted that there was an abundance of letters, cards, comments and Care Homes for Older People Page 20 of 29 Evidence: records from residents, families and friends, complimenting and thanking the staff and manager of Mill House, including some from people who had previously raised concerns or made complaints. Some of the comments seen included: ...thank you for [name]s care and best wishes... ...always a very peaceful atmosphere... ...[name] was very well looked after and was very happy. The staff were exceptionally kind at the end of life and were also very kind and caring to me. I very much appreciated the fact that two staff came to the funeral... ...nothing but praise for [name]s care, our family was very well looked after as well as [name]... ...excellent care and a very caring home. [name] was here for two years and I have nothing but praise for the staff and management... Nine of the ten surveys completed and returned stated Yes to knowing how to make a complaint and the one that stated No also stated that their relative had only just moved into Mill House. Meanwhile, training records looked at and discussions held with the manager and two staff members confirmed that they were aware of, and understood, the whistleblowing policy and that all staff had attended training for the protection of vulnerable adults. Care Homes for Older People Page 21 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home continues to provide a clean, safe and well maintained environment for residents, with further and ongoing improvements having been made to some of the tired areas. Evidence: A tour of the premises showed the premises to be safe, well maintained, clean and hygienic, with no unpleasant odours noted during this visit. A number of areas have been redecorated since the last inspection, new carpets have been laid and a new bathroom installed. The manager confirmed that redecorating and updating will continue to be an ongoing exercise at Mill House Meanwhile, all the bedrooms that were looked at continue to be very individual and personalised, with people being encouraged to bring their own furniture and other personal belongings. Many rooms have beautiful views of the gardens and the river. Care Homes for Older People Page 22 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Mill House has robust recruitment policies and practices, the staff have a good mix of skills and they are trained and competent. Evidence: Personnel files were looked at in detail for three staff members and discussions were held individually with two. The personnel files were found to contain copies of documentation or confirmation details for things such as application forms, references, identification and clear, enhanced Criminal Records Bureau (CRB) disclosures, therefore confirming that robust recruitment procedures are followed, which helps to protect the residents living at Mill House.. Training records were looked at and evidence was seen of courses attended such as first aid, medication administration, Mental Capacity Act, infection control, fire safety, health & safety, moving & handling, COSHH, food hygiene, protection of vulnerable adults and dementia. There is also a good level of staff holding NVQ2 or above. The rotas were also looked at and it was felt that the numbers are generally appropriate to be able to meet the current residents needs but it is recommended that Care Homes for Older People Page 23 of 29 Evidence: the current staffing levels and residents funding is fully reviewed on a regular basis, to ensure increasing support needs continue to be met consistently. Care Homes for Older People Page 24 of 29 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a home, which is run in their best interests by a competent manager and staff receive regular support and supervision. Residents are safeguarded and the health and welfare of residents and staff are promoted and protected by the homes policies and procedures. Evidence: It was evident from observations, discussions and records that the manager and staff have continued to work extremely hard to maintain the improvements acknowledged at the last inspection and further improvements to the service as a whole were also noted during this visit. Mill House has a good Quality Assurance process in place, which includes annual questionnaires inviting comments and feedback from residents, family, friends and other relevant people, the most recent having been May 2009. Additionally, exit satisfaction questionnaires are given to respite residents, their families and friends. Care Homes for Older People Page 25 of 29 Evidence: Feedback and comments from these were seen to be acknowledged appropriately and relevant action taken as and when necessary. It was also noted that in amongst these questionnaires were very many thank you messages and some excellent complimentary comments. Meanwhile, records and discussions confirmed that staff receive supervision on a regular basis and the staff spoken to said they felt the team had continued to work well together and that they felt very supported by the manager. Detailed health and safety records and risk assessments were seen to be up to date and relevant, thus confirming the health and welfare of service users and staff are promoted and protected. Care Homes for Older People Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 28 of 29 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). 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